| NPI | 1538100045 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WILLIAM BELLER President 870-698-1837 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: AR 3439) |
| Additional Taxonomies | 1223G0001X Dentist General Practice (Licence: AR 1832) |
| Enumeration Date | 2006-06-08 |
| Last Update Date | 2008-02-14 |